EFFECTS OF ANTECEDENT ANGINAL EPISODES AND CORONARY-ARTERY STENOSIS ON LEFT-VENTRICULAR FUNCTION DURING CORONARY-OCCLUSION

We evaluated the effects of antecedent anginal episodes and coronary a rtery stenosis on left ventricular function during coronary occlusion and the role of collateral filling in 33 patients with angina pectoris who underwent angioplasty. Wall motion abnormalities were investigate d by echocardiography and classified into hypokinesia and akinesia. Co llateral filling during angioplasty was evaluated by using a second ar tery catheter. Akinesia was observed as follows: 24% of the patients h ad >30 anginal episodes, 38% had 5 to 30, and 87% of the patients had <5 (p < 0.01); 12% of patients had a lesion of 99%, 47% had a lesion o f 90%, and 83% had a lesion of 75% (p < 0.05). Akinesia was observed i n none of the patients with grade 3 collaterals, 57% with grade 2, and 67% with grade 1 or 0 (p < 0.01). These observations suggest that the patients with antecedent frequent anginal episodes and severe coronar y stenosis have less left ventricular dysfunction during coronary occl usion. This finding may be the result of more extensive collateral dev elopment.